In late James Taylor 1965 committed himself to McLean Hospital in Belmont, Massachusetts, where he was treated with Thorazine to give him a sense of time and structure. As the Vietnam War built up, Taylor received a psychological rejection from Selective Service System when he appeared before them with two white-suited McLean assistants and was uncommunicative. He would later view his nine-month stay at McLean as "a lifesaver ... like a pardon or like a reprieve." As for his mental health struggles, Taylor would think of them as innate, and say: "It's an inseparable part of my personality that I have these feelings."
Taylor checked himself out of McLean and began to associate himself with a motley collection of people and began using heroin. He would later say of this New York period, "I learned a lot about music and too much about drugs." His drug use had developed into full-blown heroin addiction, "I just fell into it, since it was as easy to get high in the Village as get a drink." He hung out in Washington Square Park, playing guitar to ward off depression and then passing out, letting runaways and criminals stay at his apartment. Finally out of money he made a desperate call one night to his father. Isaac Taylor flew to New York and staged a rescue, renting a car and driving all night back to North Carolina with James and his possessions. Taylor spent six months getting treatment and making a tentative recovery; he also required a throat operation to fix vocal cords damaged from singing too harshly.
Taylor decided to try being a solo act and a change of scenery. In late 1967, funded by a small family inheritance, he moved to London. He recorded some demos and brought them to Peter Asher, who was A&R head for The Beatles' newly formed label Apple Records. Asher showed the demos to Paul McCartney, who later said, "I just heard his voice and his guitar and I thought he was great ... and he came and played live, so it was just like, 'Wow, he's great.'" Taylor became the first non-British act signed to Apple. Taylor recorded what would become his first album from July to October 1968 at Trident Studios, at the same time The Beatles were recording The White Album. McCartney and an uncredited George Harrison guested on "Carolina in My Mind" During the recording sessions, Taylor fell back into his drug habit, using heroin and meth, returned to New York and was hospitalized there, and then finally committed himself to the Austen Riggs Center in Stockbridge, Massachusetts, which emphasized cultural and historical factors in trying to treat difficult psychiatric disorders. Meanwhile, Apple released his debut album, James Taylor, in December 1968 in the UK and February 1969 in the U.S. Critical reaction was generally good, including a very positive Jon Landau review in Rolling Stone which said "this album is the coolest breath of fresh air I've inhaled in a good long while. It knocks me out."
Once recovered, Taylor moved to California. In December 1969, he held the recording sessions for his second album there. Entitled Sweet Baby James, and with the participation of Carole King, the album was released in February 1970 and was Taylor's critical and popular triumph, buoyed by the single "Fire and Rain", a song about Taylor's experience in psychiatric institutions and the suicide of his friend, Suzanne Schnerr. Both the album and the single reached #3 in the Billboard charts, with Sweet Baby James selling more than 1½ million copies in its first year and eventually more than 3 million in the United States alone. Sweet Baby James was received at its time as a folk-rock masterpiece, an album that effectively showcased Taylor's talents to the mainstream public, marked the direction he would take in following years, and made Taylor one of the main forces of the nascent movement. It earned several Grammy Award nominations including one for Album of the Year. (It would be listed at #103 on Rolling Stone's 500 Greatest Albums of All Time in 2003, with "Fire and Rain" listed as #227 on Rolling Stone's 500 Greatest Songs of All Time the year after.
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